c. Transverse. A transverse fracture is a straight crosswise fracture (break is at
a right angle to the axis of the bone).
d. Oblique. An oblique fracture is a diagonal or slanted fracture (not at a right
angle to the axis of the bone).
e. Spiral. A spiral fracture coils around the bone and is caused by twisting.
f. Impacted. An impacted fracture results when one bone is driven into another
bone, resulting in one or both bones being fractured and the bones being wedged
g. Pathologic. A pathologic fracture results when a bone that has been
weakened by disease breaks under a force that would not fracture a normal bone.
h. Epiphyseal. An epiphyseal fracture is a fracture located between the
expanded end of a long bone (epiphysis) and the shaft of the bone.
A fracture may be found during the primary or secondary survey of the casualty.
Life-threatening injuries (lack of breathing, massive bleeding, and shock) should be
treated before fractures since they immediately threaten a casualty's life. A serious
fracture, however, can also be life threatening. A fracture can be identified by the
following signs and symptoms.
A sign is something that can be observed by someone other than the
casualty. Bleeding, bruises, and pulse rates are examples of signs. A
symptom is something which the casualty senses, but which cannot be
observed directly by another person. Pain is an example of a symptom.
a. Visible Fracture. In an open fracture, the fractured bone or bone fragments
may be visible.
b. Deformity. The body part may appear deformed due to the displacement of
the bone, the unnatural position of the casualty, or angulation where there is no joint (for
example, the casualty's forearm is "bent" instead of straight).
c. Pain. The casualty will probably experience pain at a particular location. The
pain (point tenderness) usually identifies the location of the fracture. The casualty may
be able to "feel" the fractured bones.
d. Swelling. There may be swelling (edema) at the suspected fracture site.
e. Discoloration. The area around the suspected fracture site may be bruised
or have hemorrhagic spots (ecchymosis).